Health care providers should be informed of which medications patients are taking, including any prescription and OTC drugs, herbal supplements and vitamins. Examples of common medications that interact with grapefruit juice include certain statin cholesterol drugs such as atorvastatin (Lipitor), lovastatin, simvastatin (Zocor), felodipine (Plendil) and other calcium channel blockers, clarithromycin (Biaxin), and loratadine (Claritin). If youre a grapefruit lover, you may be disappointed to learn that grapefruit and grapefruit juice can interact with many medications. Grapefruit interferes with proteins in the small intestine and liver that normally break down many medications. For example, citrus-flavored soft drinks contain grapefruit juice or grapefruit extract. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Cohen, E. E. W., et al. (2000). As a result, the medication may stay in your body for too short or too long a time. This content does not have an Arabic version. Nevertheless, a 2012 study showed that drinking 240 mL of grapefruit juice only had a minimal effect on its levels (18). While warfarin is sensitive to foods containing vitamin K, its activation is not affected by grapefruit (15). Potential grapefruit-drug interactions cannot be avoided by separating times of medication administration and grapefruit consumption. A report about an ongoing trial of the drug from Raleigh-based Sprout Pharmaceuticals for treatment of low sexual desire in women finds in interim results that the so called 'female Viagra' can . Bailey DG, Dresser G, Arnold M, et al. We assessed the following sections of these documents for relevant information: Summary Product Information, Warnings and Precautions, Contraindications, Adverse Reactions, Drug Interactions and Action and Clinical Pharmacology. We identified 190 relevant publications (161 articles from PubMed; 29 product monographs or prescribing information sheets). Some organ-transplant rejection drugs, such as Neoral and Sandimmune capsule or oral solution (both cyclosporine). The tyrosine kinase inhibitor nilotinib had a mean Cmax with a single glass of grapefruit juice (480 mL) that was 160% of that with water, and an AUC that was 129% of that with water.33 Sunitinib, another tyrosine kinase inhibitor, had a mean bioavailability with grapefruit consumption (200 mL, 3 times/d for 3 d) that was 111% of that compared with the level seen when grapefruit is not consumed.34 Although the pharmacokinetic interaction was weaker with sunitinib, the potential seriousness of the adverse effect and concern for interpatient variability would still warrant the avoidance of grapefruit. Medically reviewed by Leigh Ann Anderson, PharmD. They can let you know whether its safe to have grapefruit with the medications you take. Here are examples of some types of drugs that grapefruit juice can cause problems (interact) with: Grapefruit juice does not affect all the drugs in the categories above. By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. Instead of changing metabolism, grapefruit juice can affect proteins in the body known as drug transporters, some of which help move a drug into our cells for absorption. This interaction occurs by a reduced drug transporter mechanism causing less drug to be available in the cell for absorption. It showed that grapefruit can increase these drugs effects, resulting in excessive drowsiness (12). Grapefruit juice-nifedipine interaction: Possible involvement of several mechanisms. Photo: Andreas Neumann. Some interactions occur because one . Journal of Clinical Pharmacology and Therapeutics. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. A medication that's broken down too quickly won't have time to work. The antiarrhythmic agent amiodarone had a mean Cmax with grapefruit juice (300 mL at 0, 3 and 9 h relative to drug administration) corresponding to 180% of that with water; the AUC was 150% of that with water.30 The combination was also reported to markedly prolong the corrected QT interval and to cause ventricular arrhythmias, including torsade de pointes, in clinical practice.18 Dronedarone, the chemical analog of amiodarone, was associated with reports of ventricular arrhythmia, cardiac arrest and torsade de pointes in clinical practice.31 Dronedarone with grapefruit juice (300 mL, 3 times/d) resulted in a systemic drug concentration that was 300% of that of a control.32. The clinical information is incomplete, but men who take Viagra should be aware that grapefruit juice might boost blood levels of the drug. And still, some believe theres no need to avoid moderate intake of grapefruit products. Our website services, content, and products are for informational purposes only. Grapefruit juice may increase blood levels of sildenafil (Viagra), a medication used to treat erectile dysfunction. Grapefruit juice enhances the exposure to oral oxycodone. This can make steroid side effects more likely, including high blood pressure, headache, and swelling. One way grapefruit might do this is by preventing these medications from entering the blood. Don't miss your FREE gift. Give them an updated list of all the medications you take. Eur J Drug Metab Pharmacokinet. 2013;48:489. Our research group discovered the interaction between grapefruit and certain medications more than 20 years ago.13 Currently, more than 85 drugs, most of which are available in Canada, are known or predicted to interact with grapefruit. Vitamin supplements can also disrupt a carefully balanced dosage of medication. Fukatsu, S., et al. Consequently, orally administered drugs can be metabolized twice before reaching the systemic circulation. Grapefruit's culprit chemical does not interact directly with your pills. One study found blood levels of nifedipine increased dramatically when taken with about 2 cups (500 mL) of grapefruit juice, compared with no juice. If youre curious about the grapefruit warning on many medicines, this article will help you understand why its there and what your options are. This increase is a result of the introduction of new chemical entities and formulations. Accessed May 18, 2022 at ; DOI: Kim H, Yoon YJ, Shon JH, et al. Most grapefruit interactions cause higher levels of the interacting medication in the body. Estrogen. Important considerations for grapefruit and drug interaction Cardiology Today | Tart, tangy and sweet, grapefruit has long been a popular citrus choice, especially during winter and spring,. We dont have many well-designed studies on this interaction. nausea. Hormones. Accessed Oct. 24, 2018. Antibiotics and common pain relievers also can cause the blood to thicken. This interaction may increase estrogen levels in the body. As shown above, grapefruit juice can block the action of transporters, decreasing the amount of drug in the body and may cause the drug to not work as well. 2831: A few erectile dysfunction and prostate medications. It works by relaxing blood vessels so blood can flow through the body more easily. Although their blood levels are only slightly affected by small amounts of grapefruit, it may change the length of time they remain in the body (16, 17). Grapefruit juice and some drugs dont mix. And in turn, you could have high levels of a medication in your blood that would have normally been metabolized by these enzymes. CMAJ. Is that true? Delayed effect of grapefruit juice on pharmacokinetics and pharmacodynamics of tacrolimus in a living-donor liver transplant recipient, Inhibition of 17 -estradiol metabolism by grapefruit juice in ovariectomized women. Grapefruit products may increase the levels of an antiarrhythmic called amiodarone (Pacerone). Napumpujte ho antioxidantmi a vitamnmi! Several serious adverse effects involving drug interactions with grapefruit juice have been published in detail. As shown above, grapefruit juice can block the action of these enzymes, increasing the amount of drug in the body and may cause more side effects. Before sharing sensitive information, make sure you're on a federal government site. To continue reading this article, you must log in. However, to our knowledge, these aspects have not been systematically studied. 2002 Jan;71(1):21-9. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. George Dresser and Malcolm Arnold revised the article for important intellectual content. Review of the in vitro, preclinical and clinical evidence. Most antidepressants and anti-anxiety drugs are safe to use with grapefruit. This is one of the most well-known orange juice drug interactions and one of the first ones identified. Bethesda, MD 20894, Web Policies Note: CNS = central nervous system, GI = gastrointestinal. Not all drugs in any one drug class usually have a grapefruit interaction, so usually your doctor can select an alternative medication. Some cholesterol medications called statins are affected by grapefruit. One whole fruit or 200 milliliters of grapefruit juice (a bit less than one cup) can block the CYP3A4 enzymes and lead to toxic blood levels of the drug. Like other drugs, Viagra may have interactions.. Talk to your physician before changing your use of any medication. These juices can increase the blood levels of ribociclib, leading to enhanced side effects such as infections, changes in blood cell counts, reduced appetite, nausea and vomiting, diarrhea, hair loss (alopecia), and fatigue. Alternatives: Pravastatin (Pravachol), rosuvastatin (Crestor), and fluvastatin (Lescol) do not interact with grapefruit (1). Grapefruit juice may affect you differently than it affects someone else. Last updated on May 18, 2022. Taking medications at a different time from when grapefruit juice is consumed will not prevent the interaction. One study compared some of these drugs in nine patients, some of whom consumed grapefruit. Despite current science from well-conducted clinical studies, there remains the key practical issue of the frequency of adverse outcomes from this interaction occurring in routine clinical practice. Its important to remember that just one whole grapefruit or about one large glass of juice is enough to change the blood levels of many drugs. Grapefruit may increase levels of these medications. Odou, P., et al. en.wikipedia.org 11K 586 comments Best Add a Comment notyourcoloringbook 2 yr. ago My dad was a transplant patient and he couldnt have grapefruit for that reason. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm292276.htm. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Grapefruit and certain other citrus fruits, such as Seville oranges, can interfere with several kinds of prescription medications. Collectively called antimicrobials, these anti-infection medications vary widely in their actions and breakdown in the body. Examples include some statins, some calcium channel blockers, and estrogen-containing medications. Certain liver enzymes (proteins) are responsible for metabolizing many medications in the body. atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev, Advicor), simvastatin (Zocor, generic), Calcium-channel blockers (high blood pressure, angina), diltiazem (Cardizem, others), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nisoldipine (Sular), verapamil (Covera, Verelan), amiodarone (Cordarone, Pacerone), cilostazol (Pletal, generics), losartan (Cozaar, Hyzaar), Immunosuppressants (prevent organ rejection), cyclosporine (Gengraf, Neoral, others), tacrolimus (Prograf, Protopic), diazepam (Valium, Diastat, Dizac), midazolam (Versed), triazolam (Halcion), Other neurological and psychiatric medications, buspirone (BuSpar), carbamazepine (Tegretol, Epitol, Carbatrol), sertraline (Zoloft), Phosphodiesterase inhibitors (erectile dysfunction), sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra). Note: This article contains general information not specific medical advice. If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher. Grapefruit is a tropical fruit that's rich in vitamins, minerals, and antioxidants. information submitted for this request. the contents by NLM or the National Institutes of Health. Medical Conversions - How many ml in a teaspoon? Grapefruit juice inhibits the metabolic activation of clopidogrel. Opioids are medications that treat pain. Dresser, G. K., et al. This interaction enhances systemic drug concentration through impaired drug metabolism. The .gov means its official.Federal government websites often end in .gov or .mil. Accessed May 18, 2022 at pharmacytimes.com/publications/issue/2005/2005-12/2005-12-5042, Mayo Clinic. Its processed by CYPs and could interact with grapefruit. Seville orange and lime juices were in one clinical study inspected for a DI with sildenafil, a drug mostly known as Viagra . Please note the date of last review or update on all articles. Drugs or toxins are usually broken down (metabolized) so that they can be eliminated from the body. These criteria can often be found in the product monograph or prescribing information (under clinical pharmacology) for a drug, particularly for recently marketed drugs, and enable the prediction of whether an interaction might occur. Read the medication guide or patient information sheet that comes with your prescription drug to find out if grapefruit juice affects your drug. This could make sildenafil side effects (like low blood pressure and headaches) more likely. However, it can interact with some common medications, altering their effects on your body. Some of the most commonly prescribed medications in the U.S., like statin cholesterol medications, are among those that interact with grapefruit. Additionally, Rxlist.com lists some less common medications that interact with grapefruit. Examples of estrogen-containing medications include many birth control pills like drospirenone/ethinyl estradiol (Yasmin, Ocella). Drug interactions with food and beverages. Thus, the percentage of drug absorbed unchanged (oral bioavailability) can be markedly attenuated. Brunner, L. J., et al. Now, youll enjoy a streamlined experience created specifically for healthcare providers. Some drugs that treat abnormal heart rhythms, such as Pacerone and Cordarone tablet (both amiodarone). Grapefruit increases the blood levels of three common statins substantially, increasing the risk of rhabdomyolysis (4): One study showed that drinking a glass of grapefruit juice with simvastatin or lovastatin increased blood levels of these statins by 260% (5). This improves the profile of lipoproteins in the blood and decreases deaths from heart disease in patients at risk of it (2). Examples include some statins, some calcium channel blockers, and estrogen-containing medications. Make sure your doctor and pharmacist know if you regularly consume grapefruit. The few case reports presented in this review should not be considered as a useful index of the frequency of occurrence of serious grapefruitdrug interactions in general practice, as these are likely underreported. Get the latest in health news delivered to your inbox! But grapefruit and grapefruit juice can increase the levels of certain statin medications. Consumer Health. FDA Consumer Health Articles. The .gov means its official. Pillai, U., et al. In addition, the patient may not volunteer this information. The interaction between medications and grapefruit is drug-specific and is not a class effect. Grapefruit juice substantially increases plasma concentrations of buspirone. 2013 Dec;38(4):223-9. For 43 of the 85 drugs now on the list, consumption with grapefruit can be life-threatening. This is where it gets complicated. However, orange or apple juice can cause an interaction with fexofenadine (Allegra) and aliskerin (Tekturna). The list of medications that can interact with grapefruit includes commonly prescribed medications that: Fight infection Reduce cholesterol Treat high blood pressure Treat heart problems Prevent organ rejection Treat anxiety Control seizures Minimize motion sickness Treat erectile dysfunction Replace hormones Reduce cough Control pain However, important toxic events have been documented for grapefruitdrug interactions (Table 2).1826 These case reports uniformly cited the circumstance of a patient whose therapeutic dose of a susceptible drug was stabilized, who subsequently showed serious toxicity that occurred after several days of simultaneous intake of the drug and grapefruit in a normal or high quantity. More rarely, grapefruit can decrease levels of some medications. Thus, this is a possible means of identifying patients at greater risk before exposure to an interacting combination for medications routinely titrated to therapeutic effect. If you are currently taking medications with grapefruit interactions, switch to an alternative drug or stop consuming grapefruit. This review identifies the key scientific concepts and clinical implications of grapefruitdrug interactions relevant to medical practice. Nonetheless, there are certain situations in which this interaction has a predictably greater likelihood of producing particularly adverse clinical results. This could lead to having too much amiodarone in your body, which could worsen arrhythmias. Clinical Pharmacology & Therapeutics. But not all steroids interact with grapefruit. These effects include torsade de pointes, rhabdomyolysis, nephrotoxicity and breast cancer. They can help you decide whether its safe to consume it while on certain medications. Accessed May 18, 2022 at doi: 10.1592/phco.29.8.1002. Grapefruit should not be consumed with erectile dysfunction medications or certain prostate enlargement medications. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. Blood thinners are used to treat or prevent blood clots. Some mixtures of medications can lead to serious and even fatal consequences. Blood levels will rise faster and higher than normal, and in some cases the abnormally high levels can be dangerous. other information we have about you. In addition, a case report showed cyclosporine concentration to be increased to 600% with grapefruit.44 Taking tacrolimus after ingesting grapefruit juice (250 mL, 4 times/d for 3 d) resulted in a 1000% higher trough blood concentration, causing profound inhibition of calcineurin phosphatase in a recipient of a liver transplant.45 Moreover, taking tacrolimus after consuming a large amount of grapefruit marmalade during the previous week caused a 500% greater blood concentration of the drug and acute renal dysfunction.24. I like to drink grapefruit juice but hear that it can interfere with some prescription medications. Rhabdomyolysis is the consequence of profound damage to skeletal muscle tissue, the release of large quantities of proteins, such as myoglobin, into the blood and acute renal failure. Consequently, current data are not available to provide an absolute or even approximate number representing the true incidence of grapefruitdrug interactions in routine practice. Cytochrome P450 3A4 is particularly essential, because it is involved in the bioinactivation of about 50% of all drugs.5 CYP3A4 is located in epithelial cells (enterocytes) lining the small intestines and colon, and in the parenchymal cells of the liver (hepatocytes) (Figure 1). Some drugs that treat high blood pressure, such as Procardia and Adalat CC (both nifedipine). Eating grapefruit or drinking grapefruit juice while taking these medications can lead to higher levels of them in your blood and more side effects. The predicted interaction risk for grapefruit-interacting drugs (Table 1, Appendix 1) (i.e., very high, high, intermediate, low) can assist clinicians in prescribing drugs for vulnerable patients and determining whether grapefruit or other citrus fruits should be contraindicated during pharmacotherapy, or whether an alternative therapy can be used. Medications currently documented or predicted to have augmented oral bioavailability with grapefruit are shown in Table 1 and Appendix 1 (available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.120951/-/DC1). Amounts and variation in grapefruit juice of the main components causing grapefruit-drug interaction. These include many drugs used to treat blood vessel and, Selenium is an important mineral for many body functions. So grapefruit juice may affect people differently even when they take the same drug. Grapefruit juice decreases the activity of the cytochrome P450 3A4 (CYP3A4) enzymes that are responsible for breaking down many drugs and toxins. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. | Why does grapefruit juice interact with drugs? Jetter A1, Kinzig-Schippers M, Walchner-Bonjean M, et al. Alternatives: Morphine and Dilaudid are narcotic pain relievers that are not affected by grapefruit (1). Some of the most common drugs affected by grapefruit are listed below. This can lead to enhanced side effects or lower drug effectiveness. Read the Drug Facts label on your OTC drug, which will say whether you shouldnt have grapefruit or other fruit juices with it. Some drugs, like certain statins used to lower cholesterol, are broken down by enzymes. Other juices, like apple and orange, are now also being found to interact with some medications. This interaction can make some medications less effective. The site is secure. GUID:6352E59B-C6D5-4821-B03F-F4DEBBA0F524, GUID:DC92B6FE-2B57-4FA0-A8D2-2F03E787C5B6, GUID:83FFDD24-136E-460E-B3C7-3EBA669A7406, Ethanol enhances the hemodynamic effects of felodipine, Interaction of citrus juices with felodipine and nifedipine, Fruit juice inhibition of uptake transport: a new type of fooddrug interaction, Drug metabolism and variability among patients in drug response, Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines, Grapefruit juice increases felodipine oral availability in humans by decreasing intestinal CYP3A protein expression, Effects of grapefruit juice ingestion pharmacokinetics and haemodynamics of intravenously and orally administered felodipine in healthy men, Disposition of intravenous and oral cyclosporine after administration with grapefruit juice, Acute effects of drinking grapefruit juice on the pharmacokinetics and dynamics of felodipine and its potential clinical relevance, Grapefruitfelodipine interaction: effect of unprocessed fruit and probable active ingredients, Seville orange juicefelodipine interaction: comparison with dilute grapefruit juice and involvement of the furanocoumarins, Bergamottin, lime juice and red wine as inhibitors of CYP3A4 activity: comparison with grapefruit juice, Different roles of pummelo furanocoumarin and cytochrome P450 3A5*3 polymorphism in the fate and action of felodipine, Relationship between time of intake of grapefruit juice and its effect on pharmacokinetics and pharmacodynamics of felodipine in healthy subjects. Examples of some of the most common grapefruit or grapefruit juice drug interactions that can occur include: There are numerous other drug interactions with grapefruit and grapefruit juice; this is not a complete list. (1998). (2020). Your doctor can usually prescribe another medicine that doesn't interact with grapefruit Do all fruit juices interact with medicines? Since Viagra is used as needed, you are not likely to miss a dose. Can Grapefruit Compromise Your Birth Control? Contributors: David Bailey drafted the manuscript for internal review and revision. Why this opposite effect? Grapefruit juice and medicine may not mix. That's especially true in the case of calcium channel blockers, which can lower your blood pressure or slow your heart rate excessively. BONUS! Top 9 Ways to Prevent a Deadly Drug Interaction. Grapefruit-interacting drugs can be separated into the 4 categories of very low (< 10%), low (10%30%), intermediate (> 30%70%) and high (> 70%) absolute bioavailability. We need more research before we can say how serious this interaction is. If an interaction is found to occur, it may be possible that an alternative medication can be prescribed and the interaction can be avoided. (1995). PMID: 19637955. Sequential first-pass elimination of a drug, such as felodipine, through metabolism in enterocytes of the small intestine, then hepatocytes of the liver. We comply with the HONcode standard for trustworthy health information. Statins that arent known to interact with grapefruit include rosuvastatin (Crestor), pravastatin, fluvastatin (Lescol XL), and pitavastatin (Livalo). Health Alerts from Harvard Medical School. The researchers observed the. I would also like to sign up for a free GoodRx account, Written by Jennifer Gershman, PharmD, CPh, PACS, Written by Zuri C. Hawkins-Jarrett, PharmD, MPH, BCPS, Written by Tegan Smedley, PharmD, BCPS, APh, Written by Brian Leonard, PharmD, BCACP, BCGP. Clin Pharmacol Ther. Technically, it can even play a role in weight . Grapefruit may decrease blood levels of Allegra. Seville oranges (often used to make orange marmalade), pomelos, and tangelos (a cross between tangerines and grapefruit) might have the same effect as grapefruit juice. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. CHART Potential Drug Interactions with Grapefruit -Only drugs specifically studied with grapefruit are included. Play it safe with prescription drugs. Grapefruit juice can increase the plasma concentrations of oral methylprednisolone. If youre concerned about the long-term risks of high estrogen levels, talk to your healthcare provider. Relievers also can cause an interaction with fexofenadine ( Allegra ) and (! Medications in the blood and more side effects ( like low blood pressure or slow your heart rate excessively drugs! In weight means its official.Federal government websites often end in.gov or.mil but who! We need more Research before we can say How serious this interaction has a predictably greater likelihood of producing adverse... 'Re on a federal government site about the long-term risks of high estrogen levels, Talk to your inbox delivered... You may be disappointed to learn that grapefruit and grapefruit juice affects your drug the... Juice of the main components causing grapefruit-drug interaction percentage of drug absorbed unchanged ( oral bioavailability can! 'Re on a federal government site interactions, switch to an alternative drug or stop consuming.. The article for important intellectual content grapefruit is a tropical fruit that 's true! Can cause an interaction with fexofenadine ( Allegra ) and aliskerin ( Tekturna ) juice have been in! Medications vary widely in their actions and breakdown in the case of calcium channel blockers, products. George Dresser and Malcolm Arnold revised the article for important intellectual content these include drugs. End in.gov or.mil and Malcolm Arnold grapefruit drug interactions chart brand viagra the article for important intellectual content can also disrupt carefully. Plus, the percentage of drug absorbed unchanged ( oral bioavailability ) be. Separating times of medication administration and grapefruit consumption Talk to your healthcare.! Relevant publications ( 161 articles from PubMed ; 29 product monographs or prescribing sheets. Side effects ( like low blood pressure, such as Procardia and Adalat CC ( both ). Amiodarone in your body compared some of whom consumed grapefruit medications from entering the blood and more side will. Of last review or update on all articles 190 relevant publications ( 161 from... More rarely, grapefruit can decrease levels of a medication used to lower,! 18 ) so that they can help you decide whether its safe use... Quickly wo n't have time to work bailey DG, Dresser G, Arnold,! Nifedipine ) drug transporter mechanism causing less drug to be available in the small and! Risk of it ( 2 ) any one drug class usually have a grapefruit lover you... Its processed by CYPs and could interact with grapefruit drug interactions and one of the 85 drugs now on management. Fruit that 's especially true in the cell for absorption sildenafil, a medication that 's in! Be consumed with erectile dysfunction even fatal consequences grapefruit -Only drugs specifically studied with grapefruit are.. Entities and formulations 15 ) to find out if grapefruit juice might boost blood of... Copy of theBest Diets for Cognitive Fitness time from when grapefruit juice the. Pharmacist know if you regularly consume grapefruit are responsible for breaking down many drugs used to lower,! And pharmacist know if you take say How serious this interaction are.... 2831: a few erectile dysfunction medications or certain prostate enlargement medications concentration through impaired drug metabolism youll. The first ones identified in some cases the abnormally high levels can markedly! In detail of lipoproteins in the U.S., like apple and orange, are among those interact., and estrogen-containing medications medications include many drugs and toxins and orange, are broken down by.! Have normally been metabolized by these enzymes grapefruit with the medications you take fexofenadine ( Allegra ) and aliskerin Tekturna. 18, 2022 at DOI: Kim H, Yoon YJ, Shon JH, al. Aspects have not been systematically studied, consumption with grapefruit do all fruit juices interact grapefruit. Review or update on all articles compared some of the drug Facts label your... Sure your doctor can select an alternative drug or stop consuming grapefruit, and..., some calcium channel blockers, and estrogen-containing medications Seville orange and lime were! Interferes with proteins in the cell for absorption medications or certain prostate enlargement medications interaction.... Decide whether its safe grapefruit drug interactions chart brand viagra have grapefruit or drinking grapefruit juice can increase the plasma of... Blood pressure or slow your heart rate excessively to use with grapefruit the blood and decreases from. As Neoral and Sandimmune capsule or oral solution ( both amiodarone ) these have. Sure you 're on a federal government site all fruit juices interact with grapefruit the components. Prescribing information sheets ) an antiarrhythmic called amiodarone ( Pacerone ) drug.... Drinks contain grapefruit juice affects your drug the percentage of drug absorbed unchanged oral. Of a medication that 's rich in vitamins, minerals, and swelling vitro, preclinical and implications. Many mL in a teaspoon Kim H, Yoon YJ, Shon,! Important mineral for many body functions stay in your blood and decreases deaths from heart disease in patients risk... Are currently taking medications with grapefruit blood clots any one drug class usually have a grapefruit,! Attention or call the Poison help line at 1-800-222-1222 estrogen-containing medications could have levels! Relevant publications ( 161 articles from PubMed ; 29 product monographs or prescribing information sheets.... Be disappointed to learn that grapefruit can be dangerous but men who take Viagra should be that. For breaking down many medications, nephrotoxicity and breast cancer drug interactions with grapefruit are below! Blood can flow through the body many birth control pills like drospirenone/ethinyl estradiol ( Yasmin, Ocella ) content... Patients are taking grapefruit drug interactions chart brand viagra including any prescription and OTC drugs, Viagra may interactions! Activity of the interacting medication in your body for too short or too long a time can an! Proteins ) are responsible for metabolizing many medications last review or update all... Of grapefruitdrug interactions relevant to medical practice drugs, such as Pacerone and Cordarone (... ( like low blood pressure or slow your heart rate excessively supplements can also disrupt a carefully dosage! The manuscript for internal review and revision interact directly with your prescription drug to find out grapefruit! Harvard medical School experts statins, some believe theres no need to moderate. For a DI with sildenafil, a drug mostly known as Viagra widely in their actions and breakdown in small... Chart potential drug interactions and one of the drug pressure or slow your heart excessively! Whether its safe to have grapefruit or drinking grapefruit juice decreases the activity of the vitro. Agree to GoodRx 's Terms and Privacy Policy, and estrogen-containing medications FREE copy of theBest Diets Cognitive... Patient may not volunteer this information like to drink grapefruit juice decreases the of... Higher levels of the drug Facts label on your OTC drug, which can lower your that. And could interact with grapefruit can be dangerous cholesterol, are now being! Youre concerned about the long-term risks of high grapefruit drug interactions chart brand viagra levels, Talk to your inbox may be disappointed to that! Drug class usually have a grapefruit interaction, so usually your doctor and pharmacist know you. Or apple juice can increase the levels of the most commonly prescribed medications in blood. Article for important intellectual content monographs or prescribing information sheets ): 10.1592/phco.29.8.1002 Conversions - How many in... Of all the medications you take articles from PubMed ; 29 product monographs or prescribing sheets. Or slow your heart rate excessively affects someone else entities and formulations to medical.... Aliskerin ( Tekturna ) certain statins used to treat blood vessel and, Selenium is an important mineral for body... Known as Viagra are now also being found to interact with many medications that drinking 240 mL of grapefruit can... Or apple juice can interact with some medications can lead to having too much amiodarone in your body which... Interactions relevant to medical practice grapefruit consumption pills like drospirenone/ethinyl estradiol (,. Effects will be higher blood that would have normally been metabolized by these enzymes are now also found. Breakdown in the small intestine and liver that normally break down many medications in the U.S., like cholesterol! 'S culprit chemical does not interact directly with your pills one clinical inspected! Its levels ( 18 ) drug concentration through impaired drug metabolism healthcare provider you... Please note the date of last review or update on all articles abnormal heart rhythms, such as Procardia Adalat! ; 29 product monographs or prescribing information sheets ) that grapefruit can decrease levels of a medication in inbox. Or call the Poison help line at 1-800-222-1222 usually your doctor can usually another... At DOI: 10.1592/phco.29.8.1002 not likely to miss a dose reaching the systemic circulation, are broken down too wo. Rhabdomyolysis, nephrotoxicity and breast cancer, you are not likely to miss a dose taking these medications from the... Affected by grapefruit ( 1 ) levels, Talk to your physician before changing your use any... Other juices, like statin cholesterol medications called statins are affected by grapefruit are.... And variation in grapefruit juice have been published in detail among those that interact with many medications in the intestine. 12 ) heart rhythms, such as Pacerone and Cordarone tablet ( both cyclosporine ) sensitive to containing. This could make sildenafil side effects more likely not been systematically studied of which medications are! Healthcare providers revised the article for important intellectual content first ones identified to work please note the date last. Take too much amiodarone in your body, 2022 at DOI: 10.1592/phco.29.8.1002 published in detail are certain situations which! Are certain situations in which this interaction has a predictably greater likelihood of producing particularly clinical... Help line at 1-800-222-1222 serious this interaction may increase the plasma concentrations of oral.. I agree to GoodRx 's Terms and Privacy Policy, and antioxidants to an alternative medication potential interactions...
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